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Opinion Contributor

The health care law in red and blue

Opposition to the health reform law is almost an article of faith among Republicans. But if you look at this map, many GOP congressional districts have much to gain as the new heath care coverage rolls out.

The map charts the law’s coverage expansion by district. The legislation’s main provisions expand insurance coverage — increasing eligibility for Medicaid and providing federal tax credits to help people buy health insurance in new exchanges. You can see that Americans living in congressional districts represented by Republicans stand to benefit as much — if not more — than those in which a Democrat holds the seat.

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The map looks at party control in the 233 congressional districts in which a greater-than-average share of people could benefit from the law — 142 are represented by Republicans compared with 91 by Democrats. The 15 districts expected to benefit the most are in California, Texas or Florida — states with a lot of votes but also a lot of uninsured people.

The law has become an election year target as well as a symbol of ideological differences between red and blue about the role of government.

Republicans cite many reasons to dislike the law that are unrelated to whether their constituents benefit from its coverage expansions and have been stating them forcefully. They argue strongly against its requirement that everyone obtain health insurance.

Democrats who favor the law do so on broader grounds, too, including support for the law’s consumer protections that would guarantee insurance access regardless of a pre-existing condition.

In the top two dozen districts — in Florida, California, Texas, Louisiana and North Carolina — a quarter or more of the nonelderly population could receive benefits from the expansion of Medicaid or new federal tax credits. This is largely the result of lack of access to employer-provided health insurance, which means large numbers of people are uninsured or trying to buy insurance on their own.

In these districts, only 42 percent of people younger than 65 had employer coverage in 2010 — far less than the nationwide average of 59 percent.

The Affordable Care Act expands the number of Americans insured in two ways. First, people with income below 138 percent of the poverty level, now about $32,000 for a family of four, will be eligible for Medicaid.

Second, those who buy insurance on their own and have income less than four times the poverty level, about $92,000 for a family of four, will be eligible for federal tax credits to subsidize their health insurance premiums.

This means that more than one in six Americans younger than 65 could have access to help with their health insurance costs as a result of the law. Red and blue congressional districts look remarkably similar here. Republican districts have, on average, an estimated 18 percent of the nonelderly people eligible for help with health insurance costs under the reform law. Democratic districts have about the same, 17 percent.

Ideological differences aside, this map shows that constituents in Republican and Democratic districts have an equal interest in the law’s insurance coverage expansions — its largest and most costly provision.

You might never know this from the debate we are likely to hear between now and the November election — whose results will be critical to whether or not this law, which has split the country, actually is implemented.

Larry Levitt is a senior vice president at the Kaiser Family Foundation, Drew Altman is the president and CEO, and Gary Claxton is a vice president.

noreen, the problem of the uninsured is real, and Republicans have been unwilling to offer any solutions that come close to addressing the problem. So the Democrats went ahead with a reasonable, market based solution. Since then, Republicans have demagogued it with every epithet they can think of, but purely for political reasons, and playing low information voters like a fiddle. If Obama is re-elected, and it is looking more and more likely, the ACA is going to be with us a long, long time. So do some critical thinking and come up with some actual improvements, because the law isn't going away..

noreen, the problem of the uninsured is real, and Republicans have been unwilling to offer any solutions that come close to addressing the problem. So the Democrats went ahead with a reasonable, market based solution. Since then, Republicans have demagogued it with every epithet they can think of, but purely for political reasons, and playing low information voters like a fiddle. If Obama is re-elected, and it is looking more and more likely, the ACA is going to be with us a long, long time. So do some critical thinking and come up with some actual improvements, because the law isn't going away..

The GOP had plenty of great reasonable , free market ideas but were all soundly rejected. Or have you forgotten the " we won" crowing of the dems ? Crafting this monstrosity behind closed doors in the dead of the night? Besides, this is not about health care. It is about wealth redistribution and growing a huge centralized government. It is the dim watt bulbs among us whole swallow the propaganda hook line and sinker. I have every faith that with the violation of the first amendment , that the SCOTUS will most assuredly toss Obamacare into the dumpster where it belongs. Obama's chances of re-election are very dim indeed. Our nation is in shambles under his stewardship and we have had enough.

I thing Drew Larry and Mo here need to step away from the bong. Obamacare sucks big wind and the good people of the U.S.A are not going to put up with it. I have to wonder if the think that they are changing anybodys mind by telling them how great this sham is. Medicine and doctors will all be free and Oboma will pay off our credit cards and our houses and the more we borrow the richer we will be and blah blah blah..............

Red states insist on an on your own approach that lets them have lower taxes, but often leaves the poor and middle class more screwed when tragedy strikes (such as being unable to work due to illness/injury, losing a job and not being able to find one for months from a bad economy, etc).

Blue states better protect their citizens better from such tragedy with safety net programs, but need higher taxes to pay for them (unless they want to irresponsible and just borrow to pay for it like the federal government, but that's not an option for most states).

Red states decry people mooching off the tax payer. Yet all but 1 red state is a net 'moocher' of tax dollars (Texas is the 1 red state exception, though just barely from what I recall). The rest of the red states take in more federal tax dollars through benefits/spending in their state then they pay in.

So the red states are fiercely saying "don't you dare give me free money, that's government tyrany". And the blue states insist on more protections for the people in red states.

Such a system may give redish/red states decades of prosperity (and electoral college growth, redish states tend to be the ones growing the most, and blueish ones losing electoral votes), but it's unsustainable long term.

And this is just one more reason why our political system is so screwed up in America. Personally I think we'd be a bit less screwed up if we had a paralimentary system like most of the world with an elected government.

How many cases of Mental Illness is so related to & is misdiagnosis for such things of, Obama care & Appointed FDA Margaret Hamburg, who in 2009 refused to hold the makers of such things as or ban Doctors from using or recall the use of mercury used in dental work known as Amalgam Note: those “silver fillings” aren’t silver. Its mainly mercury ! Time released poison! Information call "1 651 644 4572" "dams@usfamily.net"? or send 4 imfo @ DAMS 1043 Grand Ave, #317 St Paul MN 55105

hazards & links reads like views of Epidemiological research for causes of Gulf War Syndrome for those with Amalgam Gulf war syndrome unexplained chronic multisymptom illnesses and undiagnosable illness not to over ADHD Schizophrenia etc, I am just wunder of the people Obama is seeking to push for force care to buy how many are misdiagnosis with related IIlnesses , Note Book to read Interaction Between Electromagnetic Radiation? and Toxic Metals by Charles Masur, MD

How many cases of Mental Illness is so related to & is misdiagnosis for such things of, Obama care & Appointed FDA Margaret Hamburg, who in 2009 refused to hold the makers of such things as or ban Doctors from using or recall the use of mercury used in dental work known as Amalgam Note: those “silver fillings” aren’t silver. Its mainly mercury ! Time released poison! Information call "1 651 644 4572" "dams@usfamily.net"? or send 4 imfo @ DAMS 1043 Grand Ave, #317 St Paul MN 55105

hazards & links reads like views of Epidemiological research for causes of Gulf War Syndrome for those with Amalgam Gulf war syndrome unexplained chronic multisymptom illnesses and undiagnosable illness not to over ADHD Schizophrenia etc, I am just wunder of the people Obama is seeking to push for force care to buy how many are misdiagnosis with related IIlnesses , Note Book to read Interaction Between Electromagnetic Radiation? and Toxic Metals by Charles Masur, MD

Why all the vitriol about a modest improvement in this nation's healthcare. Okay, here we go TEA Baggers, the Supreme Court will not strike down the law because the mandate was the Heritage Foundation's idea. Let's be honest, the Roberts Court majority is just a bunch of Catholic New Jersey hacks who never had an original idea in their lives and (let's face it) don't have it in them to go against an idea of a conservative think tank like Heritage. Personal responsibility, anyone? Media clips abound of conservative GOP elected officials touting the mandate as the only way to go. Also, the Supreme Court, and ultimately conservatives, if they find a way of getting Romney in, will never give up the Affordable Care Act's boon to private insurance. Again, Republicans don't have it in them to give up free government money to private corporations.

What conservatives who have been filled with three years of FoxNews and hate radio never say is WHY they hate the Affordable Care Act. When one loses the dog whistles, the racism, and vitriol, they have no answer. As this article shows, red states will benefit the most from the law. Would these same people be decrying the home mortgage write off as "Communism/Socialism" if it were being introduced now? Then why would they object to being able to write off the insanely expensive insurance premiums that are a national embarrassment? The GOP has no plan, and despite their straw grasping, tort reform is a red herring. Besides, lawyers lobbies aren't on board with that and some lawyers and other educated people are actually Republican.

To illustrate Republican mindset, here in Florida, during the astroturf tea party summer of 2009, there were meetings about the new healthcare law, yes the meetings where fake grass roots organizations and FoxNews told gullible (newly unemployed ) people still outraged by Bush's TARP that it was their duty to be disruptive at these town halls. Anyway, some hapless woman asked our Republican lawmaker what she should do about being jobless, terminal, and without healthcare. Being embarrassed by his party (and talking points) lack of answers, the congressman told her to contact his office so he could find the appropriate people to help her. Crowd cheers, compassionate conservatism reigns! The problem was, a local tv station followed up on this woman's story. The congressman did indeed give her his card. She called his office to get the run around. The tv station tried to help. She showed up at his office dozens of times, was put on hold, transferred to different office staff, and eventually given a short list of local charity organizations. The tv station followed through with the woman, found that none of these charity organizations offered any healthcare help whatsoever, and reported this back to the congressman. Now this is 10 months later, and the memories of the original town hall are dim. Finally, FINALLY, this woman got an honest answer from the congressman, "we don't offer help with heathcare."

SUMMARY OF SELECT PROVISIONS AFFECTING PROVIDERS AND SUPPLIERS PREPARED BY HOOPER, LUNDY & BOOKMAN, INC. Lloyd A. Bookman, Esq., John R. Hellow, Esq., Editors MARCH 2010 ...7. Premium Ratios (PHSA Section 2718) The Act attempts to ensure plans will spend the vast majority of premiums on patient care as opposed to administration. The Act will require plans in the group and individual markets, (including grandfathered plans, but not self-insured plans) to report to the Secretary the amount of premium revenues spent on patient care, actions to improve quality, and all other non-claims costs

. Starting in 2011, large group plans that spend less than 85 percent of premium revenue on reimbursement forclinical services and activities that improve health care, must pay an annual rebate to each enrollee. Thus, if more than 15 percent of a large group plan’s premium revenue is expended on non-claims costs,the plan will be penalized. Plans in the small group market may not permit non-claims costs to exceed20 percent of total premium revenue...

My fellow Polito commenters...

-My understanding is the Insurance industry was at a 65%/35% ratio of monies paid out verses "evil" profit, operating expenses and monies put aside for catastrophic loss. The new law requiring 85%/15%...I never found the new laws actuarial tables to show that those numbers are sound business wise. Nothing like setting up a business to fail with a law, is there? Do you think there is any chance this 85%/15% ratio was picked as a number designed to appease the masses? Historically, a populist politician tells people what they want to hear, not facts-

Yeap. In fact, did you know that Currently, many insurance companies do not allow adult children to remain on their parents' plan once they reach 19. Companies cannot do that any more. Search onilne for "Penny Medical" and you can insure your kids if you are in the same boat.

Not sure why the Left is so enamored of this healthcare bill. Liberals like Pulitzer Prize winning author Chris Hedges have called ObamaCare "a disastrous bill written by corporate lobbyists." It's 2000 pages of essentially the equivalent of the bank bailout bill for the pharmaceutical and insurance industries. Big corporations get $400 billion in subsidies and the White house even handed out exemptions to not insure chronically ill children just to protect large corporate interests. The entire bill renders US citizens impotent against large corporations that have no interest in a free market of competing goods and services. ObamaCare is a bill that angers Progressives, Conservatives and most of all, Libertarians.